Solid Tumors (Breast, Thoracic, GI, GU, Gyn, Head & Neck, CNS, Skin, Sarcoma)
Core concepts
For each site, know risk factors, presentation, staging, molecular drivers, and standard first-line therapy. Breast: ER/PR/HER2 subtypes, staging, neoadjuvant vs adjuvant, CDK4/6 in HR+/HER2− metastatic, PARP in BRCA. Thoracic: NSCLC vs SCLC, EGFR/ALK/ROS1/KRAS, PD-L1, staging, SBRT for early stage. GI: oesophageal/gastric (HER2, MSI), colorectal (KRAS/NRAS/BRAF, MSI, sidedness), pancreatic, hepatocellular (sorafenib/lenvatinib, transplant criteria). GU: prostate (PSA, Gleason, AR-targeted agents), renal cell (clear cell, VEGF/TKI, immunotherapy), bladder (BCG, cisplatin-based neoadjuvant). Gyn: ovarian (BRCA, PARP maintenance), endometrial (molecular classification), cervical (HPV, chemoradiation). Head & neck: HPV status, cisplatin-RT, immunotherapy. CNS: glioma grading, IDH, MGMT, glioblastoma standard. Skin: melanoma (BRAF, immunotherapy), basal/squamous cell carcinoma, Merkel. Sarcoma: grade, margins, anthracycline-based therapy, GIST (KIT/PDGFRA, imatinib).
Traps
Questions test biomarker-driven eligibility (do not give anti-EGFR in KRAS-mutant colorectal; do not give trastuzumab without HER2 positivity). Distinguish subtype-specific therapy. Watch sidedness in colorectal and HPV status in oropharyngeal cancer. Do not conflate SCLC (chemotherapy ± immunotherapy, rarely surgery) with NSCLC.
Worked example / rule of thumb
Metastatic colorectal cancer, RAS wild-type, left-sided: anti-EGFR + chemotherapy is appropriate. If RAS-mutant: anti-EGFR is contraindicated; use VEGF-based or chemotherapy backbone. Rule of thumb: match the drug to the biomarker and the site - no biomarker, no targeted drug.